Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about active management of the third stage of labour. And you can find written notes on

this topic at zero to finals.com slash third stage or in the labour and delivery section of the zero Zero to Finals, Obstetrics and Gynaecology

book. So let's get straight into it.

The third stage of labour is from the completed birth of the baby to the full delivery of the

placenta. There are two options for the third stage,

physiological management and active management.

Physiological management is where the placenta is delivered by maternal effort,

just by the mum, without requiring medications or cord traction.

Active management of the third stage is where the midwife or the doctor assist in delivering the placenta.

This involves a dose of intramuscular oxytocin to help the uterus contract

and careful traction on the umbilical cord to guide the placenta out of the uterus and vagina.

Active management shortens the third stage and reduces the risk of bleeding, but it can be associated with nausea and vomiting.

Active management is routinely offered to all women to reduce the risk of

postpartum hemorrhage. It's also initiated if there is hemorrhage or there's more than a 60

minute delay in delivering the placenta, which is referred to as a prolonged third stage.

Let's talk about the steps.

Active management of the third stage involves an intramuscular dose of oxytocin

after delivery of the baby.

After the baby is delivered, the cord is clamped and cut within five minutes.

There should be a delay of one to three minutes between delivery of the baby and clamping of the cord

to allow blood to flow to the baby, unless the baby needs immediate resuscitation.

...